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813-780-0020 City of Zel hyrhills Permit Application Fax-813-780-0021 <br /> ; � Building Department • <br /> ' � Date Received � —p�t. � Phone Co tact for Permitting a�� l���-- /� g5 <br /> _�-} I7 - <br /> Owner's Name ch�r�es � � ��( L G �J� Owner Phone Number <br /> 2 (� / I �(' <br /> Owner's Address , ��J IJe l G(' C��C-% Owner Phone Number <br /> Fee Simple Titleholder Name I Owner Phone Number <br /> I <br /> Fee Slmple Tltleholder Address I <br /> JOB ADDRESS ��a�a 1J�`�� �/���C� �"�,, ��� r hi 1Cs LOT# � <br /> SUBDIVISION �)/v er V • 1 P I CEL ID# �—f�(sl� 1� OCJ — ��V O I L O <br /> WORK PROPOSED NEW CONSTR A ID/ALT � SIGN'NED FR�OM PROPERTY T�nce)DEMOLISH <br /> � INSTALL B RE�PAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK � FRIPME � STEEL Q V 0'7 <br /> DESCRIPTION OF WORK I�S��L �I bd P�I�C�6�� �V'� �� S�In GCJl�• <br /> r�' /�' (� 1D ' <br /> BUILDING SIZE p� X�—l SQ FOOTAGE li � HEIGHT , <br /> �(�S <br /> /�UILDING "� � p/y`• d VALUA710N OF TOTAL CONSTRUCTION ��v <br /> O c..C� � <br /> (� , � �ELECTRICAL 3 AMP SERVICE � PROGRESS ENERGY � W.R.E.C. <br /> ^\�\J i(� <br /> V1 \�� OPLUMBING $ <br /> � <br /> \�� QMECHANICAL $ VALUAT ON OF MECHANICAL INSTALLATION `�/��� ,��JJ,�I r��'���. <br /> � l/ �� ����� v <br /> �GAS Q ROOFING Q SPECIALTY � OTHER � (�! <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO� �j �(JC <br /> J � <br /> I L <br /> BUILDER �� �COMPANY L� "(, Il] ��U��IIIJU�i <br /> SIGNATURE REGISTERED Y N y E CURRE� /N <br /> I <br /> Address �� �� �l T � I � License# , CC ���j�b <br /> I <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y(N � <br /> Address I License# <br /> I <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address I License# <br /> I <br /> MECHANICAL COMPANY <br /> SIGNATURE �EGISTERED Y/ N FEE CURRE� Y/N <br /> Address I License# <br /> � <br /> OTHER CIOMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> i <br /> Address I License# <br /> IIIIIIIIIIIIIIIIIIItlllllllllllllllllllllllllllllllllllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)s�t of Energy Forms:R-O-W Permit(or new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Permit forlsubdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days afler submittal date. Required onsite,Conslruction Plans,Stormwater Plans w/Si�t Fence installed, <br /> Sanitary Facilities&1 dumpster Site Work Permit forfall new projecls.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW constr�U,tion. <br /> Directions:• • • • • • • • • • • • • • • • • • • • • I , <br /> Fill out application completely <br /> Owner 8 Contractor sign back of applicalion,notarized <br /> If over 52500,a Notice of Commencement Is requlred. (AIC upgrIades over$7500) <br /> " Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same - I <br /> OVER THE COUNTER PERMI171NG (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />_ I <br />